I grew up in Ohio and had never heard of a doula until I moved to the east coast. I know a handful of people who have used them and know a friend of friend of a friend’s cousin who is one, so I wanted to understand more about what they do. I vaguely remember that there may have been a Frazier (Best. Show. Ever) episode on doulas. I reached out to Melissa Carrick who is a doula and educator in West Seneca New York for some helpful Q&A.
You can find Melissa here: https://www.wellnesswithinwny.com/birthyourway
I have heard of birth doulas, post partum doulas, etc. What types of doulas are there and can you give an overview of what services they provide?
* The term Doula is Greek for “to serve.” I literally use the term for anything! I have a business coach who is my business doula. A fitness coach who is my fitness doula, etc. What we hear and see most commonly are birth and postpartum doulas. A birth doula provides birth preparation and support, usually accomplished through two or more prenatal visits which include options for birth, birth planning, and coping & comfort measures during labor; continuous labor support throughout; and usually one postpartum follow up visit. A postpartum doula helps the family after birth to assimilate and integrate their “new normal.” They may help with such things as feeding and sleeping patterns, baby care and soothing, and providing additional resources of any mood disorders are a concern. In both cases, doulas do not replace the partners or take over, but rather give the families the tools and hold space for them to empower themselves in any situation. There are also end of life doulas that can help people and their families as they near end of life, to help the transition and the coping process be more comfortable, peaceful and respectful.
How do you choose the right doula – how do you know if they are right fit for you?
When choosing a doula, consider the skills that are important to you, rather than their experience. A doula should be kind, genuine, respectful of all choices, compassionate, caring, empowering, a great communicator… Experience in birth is important, for sure, but you want to be comfortable, uninhibited, and yourself around this person. Inviting someone to your birth space is a big deal. Are you comfortable making noises, being naked, being vulnerable around this person? It’s more of a feeling that you get when you meet with them. If you have any special circumstances or high risk consideration, it may be valuable to ask their experience. Ask open ended questions like, “how would you handle….?” “How will you support me and/or my partner, or include my partner…?”
What type of training do doulas typically have?
Training may vary. There are many online certifications, and some in person trainings. It usually involves doing some amount of “book work,” and reading, the learning part; in addition to The practical part- taking a childbirth education class, a breastfeeding class, finding a mentor to shadow 3 births, and then leaning on that mentor as you begin to take on your own clients. Currently there are no regulations on doulas so certification is not yet “required.” You may find a doula that’s been supporting births since they witnessed their siblings being born! I believe it is a calling that seeks you out!
Does the doula’s role change if you have a c section, whether scheduled or emergency?
The underlying role does not change. That is, to provide comfort, support, and coping strategies for the family. If it is planned, the doula and family have time to mentally prepare (which is all birth! Birth is more mental prep than anything!) and discuss options to have a gentle or family oriented cesarean, which would include a clear drape or cropped drape to see the baby as they are being born, skin to skin in the OR, the family staying together throughout the process, music, essential oils, delayed cord clamping, etc. If it becomes emergent, the doula will have already discussed the plan for this ahead of time during the prenatal education sessions. Hopefully the family has planned and understands the options and urgency that arise in this situation. I encourage the partner and myself to stick right by the moms side as long as possible to keep our attention on her, keep her grounded and focused, as all other attention is on getting things moving quickly.
If you are hiring a doula, at what stage in pregnancy should you start interviewing them?
Anytime!! It’s never too late or too early. I’ve had people hire me at 8 weeks at 36 weeks! Those that hire early don’t usually schedule a first visit until the second trimester and the second visit in the third trimester, but every doula does things differently.
Do doulas work in groups -or what happens if you are not available when I go into labor?
A lot of doulas are independent contractors, or work for themselves, but often have back up doulas in place. Some doulas work for agencies or collectives where there is a partner system and the two (or more) doulas share an “on call” schedule, and rotate. This is a great question to ask when interviewing: “do you have back up? Vacations planned? How many births do you take a month? Can I meet your back up?”
What are the typical fees for services performed?
Fees can vary. A lot of “doulas in training” offer lower rates until their training is complete. Some students offer free services until qualified by their certifying company. On the low end, average could range from $300-$600. For more experienced doulas, it may range from $800-$1500. In larger metropolitan areas like NYC, they may be well over $2000. Please consider the prenatal and postpartum visits, the on call nature of the job, the unpredictable hours and continuous support throughout labors that may last upwards of 48+ hours. Invaluable!
Have you hired a doula or are you a doula? We’d love to hear from you.